Age-specific risk factors for advanced stage colorectal cancer, 1981-2013

Introduction Epidemiologic studies have identified an increase in colorectal cancer (CRC) among younger adults. By using a statewide population- based cancer registry, this study examines sociodemographic and clinical disparities in CRC and characterizes advanced stage CRC risk factors with specific attention to age-specific risk factors. Methods Data from the Florida Cancer Data System from 1981 through 2013 were analyzed for adult CRC patients. Patients were divided into 2 age groups: younger than 50 years and 50 years or older. Stage of presentation was categorized as early (localized) or advanced (regional or distant). Multivariable logistic regression models adjusted for sociodemographic and clinical characteristics were fitted to identify risk factors for advanced stage CRC presentation. Adjusted odds ratios were calculated with 95% confidence intervals. Results From 1981 through 2013, there were 182,095 Florida adults diagnosed with CRC. Those aged younger than 50 years were significantly more likely to have advanced stage CRC compared with those aged 50 or older. Among those younger than 50 years, current and former tobacco smokers and those of black or other race were significantly more likely to have advanced stage CRC. Among those aged 50 or older, Hispanics had significantly higher risk of advanced stage presentation compared with non-Hispanics, although this association was not significant in those younger than 50 years. Conclusion We identified significant age-specific risk factors for advanced stage CRC presentation. With CRC incidence on the rise among younger adults, it is important to identify and to target screening and interventions for groups at high risk for advanced stage CRC presentation.